September 22, 2013

On Imperfect Perceptions

All societies, civilizations and political regimes alike ultimately turn upon prevailing public opinion. How's that for a blinding statement of the obvious? More conspicuous still is the relentless persuading, proselytizing, cajoling and would-be-convincing-arguments offered by all sides, all in hopes of moving the collective zeitgeist, or world view, their way. What's not as clear, however, are the obstacles that inhibit these hoped-for shifts in popular opinion: obtacles to workable consensus and cripplers to progress!

Previous posts have touched upon The Tragedy of Broken Trust and the problems that the lack of a "workable consensus" bring to a Dwindling Democracy. I've used the divided views (and botched political process) of Obamacare to illustrate these points in the past and will again below. But first, I'd like to briefly explore a common interpersonal communications breakdown: one that IMHO underpins a good portion of these often unconstructive "divisions."

Sound policy and position-building requires us to distinguish between facts, perceptions and personalities; in a free country, every person has the prerogative to form their own opinion on their own perceptions on the facts as presented.
But, as Democrat hero Senator Daniel Patrick Moyanhan once said while "Everyone is entitled to their own opinions, they are not entitled to their own facts." And, in my own opinion, no one should presume that other's perceptions on a given issue are necessarily linked to their personality, integrity, character...in short, others' value. In other words, the mutual villification of individuals, simply upon a percieved diasagreement on one (or more) issues, too often results in general diagreement on all of them (not to mention generaly diagreeable relations all along the way).

Turn back now back to Obamacare (for illuminous illustration via a mangled measure;-). The eponymous nature of the name itself demonstrates my point: i.e., The Affordable Care Act (ACA), for better or worse, has become joined at the hip with our standing President. Consequently, many that support his party's particular approach to healthcare reform hold their position mainly because they perceive it as, in fact, Obama's signature domestic policy piece; doubtless there are others who hate it just because they hate him! Sadly, Senator Moynahan notwithstanding, perceptions sometimes carry the weight of fact even when there are abundantly ample, clear and concrete facts upon which either side could make legitimate (non-Obama based and certainly non-racially bent) cases.

Rather than any recap any of the mountainous "cases" (for or against) Obamacare here, I'll try to make but two IMHO heretofore less-vetted points: the first involves an unfortunate slur word that Republicans have coined to denigrate a necessary component of any healthcare reform scheme; and the second comprises an attempt to redress the revisionist history against which Democrats claim statutory authenticity.

First the "Slur word." While most of us could dismiss the likes of Michelle Bachmann's rantings over death panels, mainstream Republicans' echoing of this same distorting reference is IMHO unforgivable. Some form of rationing (to regulate consumption of scarce resources) is essential. Would anyone really prefer that a message go out across the land (to the mid-level bureaucrats that will, ultimately, administer whatever form of public health that we end up with) "you can sanction most any and every treatment or tonic that anyone wants?" Of course not. Indeed, one could argue that one of the main reasons that U.S. healthcare costs are so badly out of whack is that America lacks for enough folks with buying/paying power, and the will, to say enough is enough: not everyone can have all the Botox, ED drugs and hip replacements that they want and have them paid for by their neighbors (or the presumably limitless supply of rich folks across town). That said, does anyone feel good about mid-level bureaucrats making the countless day-to-day covered/not-covered decisions implied by a national health plan? A pragmatist could, in fact, point to this as perhaps the most intractable of Obamacare's congential defects: i.e., does anyone really think that goverment is going to be better at "saying no" to its constituents than insurance companies have? How many elected officials can/will stand up to super-angry parents' (and/or parents' caring childrens') outrage over their loved one not getting the care that some doctor somewhere says might help relieve their suffering or even save their life? Call `em what you will, so long as we have third-party payers, we'll have to have other third-party panels that must, more often than we'd often like, say no. Characterizing them as death panelists is, therefore, reckless and irresponsible.

On to the ACA's tortured Congressional history. The President himself has now gone to "personalizing" persistent opposition to the edge of narcissism: e.g., last week he chided Republicans, telling his ever-fawning followers that "they [Republicans] are not focused on you; they only want to mess with me." True enough, I suppose, that not everyone in Congress admires the President as much as some; but, personal animus is not the prime mover of their positioning. Ironically, it's just the opposite [of Presidents Obama's own rants]; many Republicans in Congress fear that our representative Democracy might actually work as advertised: i.e., that disgruntled ACA-hating constituents might "primary" certain elected representatives right out of office if they don't remain steadfast in their word to oppose this clearly-flawed program!

And it's the "revisonist history" that "disgruntles" many most.

How many more times must we hear that Obamacare was "duly passed by congress (presumably at the will of the people), upheld by the Supreme Court and then re-ratified in the 2012 election"? I submit none of this actually happend, at least not to the extent implied by the Administration's proponents! Here's a more accurte chain of events...

Having narrowly won (±53/47%) the 2008 election partly upon a vague promise of universal healthcare, and with both houses of Congress in firm Democratic control, the new President turned his attention to Economic Stimulus, Guantonimo Bay, Climate Change and other issues of higher immediate interest [to him]. Meanwhile, he turned healthcare reform over to the semi-capable hands of Harry Reid and Nancy Pelossi: an overhaul of fully 1/6th of the American economy left to hyper-partisan political hacks!

As any political pundit knows, major policy shifts only occur with bi-partisan support. Contrary to some commentary, the Senate's de-facto super majority requirements (selectively invoked via long-standing filibuster rules) were never met on the way to ACA. Thus obscure Budget Reconciliation techniques were used to get around this time-honored (albeit sometimes pesky) tradition; this in spite of the fact that the closest thing to an actual public referendum was Republican Scott Brown's miraculous election in the most democratic of States (Massachusetts) predicated almost entirely upon his opposition to the ACA. Then and now all public opinion polls show overwhelming popular opinion against this opaquely bloated bill. Prophetically, Mrs. Pellosi remarked that, inasmuch as she nor anyone else knew what was actually in the bill, "we have to pass it to see what's in it." I didn't pass, but was enacted nonetheless; and now that we are—seeing the burgeoning flood of new regulations that attends it—we (the people) like it even less!

Perhaps the most onerous of Obamacare's many untasty bits was it's individual mandate: i.e., its curiously vital tactic of requiring low-risk individuals to effectively subsidize higher-risk folks within large state-based pools (a.k.a., Exchanges). This, we were assured, would not affect those "that liked our current plans [and] could keep them." In a move that suprised most everyone (including the Court itself!) the Supremes chose not to strike down the individual mandate; instead, they properly ruled that the Constitutional powers reserved to the states still are (and it was up to each state to implement the Exchanges, expand Medicare and generally administer the overall program). Inasmuch as most states have elected to take the whole of the Court ruling (and elect not to participate) it has fallen to the Fed's to do it all from Washington: and address from which the greatest management failures in American history (witness Public Education, Housing, Post, etc) have befallen us.

Then, in 2012, and in the midst of an election fraught with myriad complexities, President Obama even more narrowly won relection (±51/49%) against an even weaker opponent. Yet, he contends, it was all because we so want Mrs Pelossi's misbegotten health plan. If Democrats actually believed that there was any semblance of popular support, why not re-open the bill for bipartisan modification? The answer is obvious: they are well aware of how thoroughly rejected the program would be

In summary, the contention that, somehow, Obamacare reflects the "duly-passed will of the people" doesn't hold water. Those saying otherwise are either national health plan ideologues (willing/able to bend facts to their own perceptions, occasionally demonizing those with different perspectives) or they've just not been paying much attention. But, stranger (arguably worse) things have happened in America's past, and we'll get through this too. But, isn't it time that we begin a more honest debate leaving unhelpful words and phrases like "death panels" and "duly-passed, confirmed and re-confirmed" assertions behind?

Comments

Doug,

We’re already regurgitated the reconciliation point on Facebook. No need to do that again here, but bottom line is IMHO the process is no longer unusual or rare. It got to that point because of the abuse – yes in both parties – of the Senate’s filibuster rules. But it’s also important to note that the use of “cloture” – essentially the threat of filibuster requiring at least 60 votes to even bring a bill, any bill, to the floor for an up or down vote – has been the very public and bragged about tactic of the Senate Minority Leader since the election of 2008, and its widespread use since then can only be described as an effort to obstruct the normal legislative process. That’s why those of us who claim that the law was duly passed, affirmed by the Supreme Court, and is the law of the land, do not accept that such a claim is opinion. It is fact. It passed. It really did happen. It was in all the papers. There were votes recorded and everything.

Would it have been better if more Republicans had endorsed it? Sure, and I guess it would have also better if more Democrats had endorsed the Bush tax cuts that took a 50-50 tie breaking vote from Dick Cheney to pass back in 2003. (Talk about a bill that had widespread impact, especially for deficit spending.) And, remember for a while there Obama, Max Baucus, Harry Reid and company were trying to work with Charlie Grassley to fashion a health reform bill that got at least some minority party support, by among other things, taking out a government option plan. But then Charlie got bitch-slapped by Mitch McConnell and fell back in line and that was that. To counter now (in 2013) that the law was not legitimately passed because reconciliation was used in 2010 and we ought to put it on hold until yet another election cycle because maybe those of us who don’t like it can get enough new House and Senate seats to muster up a veto override of a repeal; well that just seems beyond all reason.

On the other hand, the claim that the ACA institutes “death panels” has been and continues to be fiction. A damnable lie. Not even close to being a fact. If it was meant to be a comment on the law’s inclusion of language authorizing treatment effectiveness research – and we all know it wasn’t, it was aimed at scaring people – then it might, just might, have led to a better, more thoughtful discussion of that subject and how it relates, ultimately, to health care spending in the manner you describe. Or if it was just a misunderstanding of the provision that would have allowed Medicare to pay for end-of-life discussions between patient, patient families and physicians, it could be forgiven, I suppose. But that’s not what happened. It was a tactic employed first by Sarah Palin and then by Michelle Bachman and it continues to be associated with minds of that caliber.

And, wow, Scott Brown’s 2010 election in Massachusetts was a national referendum on Obamacare? And Obama’s election in 2012 wasn’t? Seriously? I wonder what Brown’s loss in 2012 means then? Call in the revisionist historians. You’ll need some help spinning this yarn, Brother Douglas. (Perhaps coach Wallace?)

Thanks for the opportunity to respond. I’ll end with this.

Many of us on the left thought that the No Child Left Behind law pushed by President Bush after he first took office was a flawed attempt to address a legitimate issue – and a huge one at that – about how to ensure quality public education standards. In scope, if not in federal budget spending, NCLB was a landmark bill. But rather than fight it at every turn, rather than offer weak, pseudo reforms just to claim the Democrats had a plan, the party’s leadership actually helped. Thus you had this rare bipartisan scene of George Bush and Ted Kennedy standing together when the NCLB was passed and signed into law.

It wasn’t long before the flaws in the law began to show up, but the Democrats didn’t stage 40 symbolic votes in the House trying to repeal it. They moved on to other issues. Even when they regained control of the House, there was no major repeal effort mounted against it and certainly no calculated, fact-challenged campaign to discredit it. Opponents simply kept pointing out the problems and, over time, states and local school boards did the same. With almost every year and with every new Congress NCLB was amended and state waivers were granted, but the law remained in effect.

It wasn’t until recently when with a new occupant in the White House, a new secretary of education and – interestingly with a dash of bipartisanship at least at the state level – that NCLB has been so rewritten that it seems very different than what was passed in 2001.

That’s how the process is supposed to work. Congress passes a law. The administration implements it. If it doesn’t work, Congress passes amendments to fix it. If it can’t be fixed Congress passes a law that repeals it.

The ACA is the law. If you don’t have the votes to repeal it, find them in the next election, or the next, or elect a new President who agrees with you. Don’t stage one economic crisis after the next until you get your way. Until then, let’s get this thing started. It’s not like it’s important or anything. We’re only talking about the health and well being of the nation’s citizens.

Suffice it to say that if a substantial number of people think Op-Ed Columnist Paul Krugman's (simplistic/dreary) pieces are insightful - yours would (by comparison) appear positively transcendent! And, as an (even if oblique) observation, the more complexity any given topic contains, the easier it is to obfuscate any of the subtle nuances and associated deeper currents the issue might portend (again - simply by use of the magician’s venerable technique of misdirection – meaning in this case, a mere simulacrum of loud recapitulations of ideologue vernacular that becomes a stand-in for well-reasoned assessments). One of the oldest clichés of all may apply: e.g., telling a half-truth with (seeming) compassion and near endless repetition unfortunately captures the evanescent mindshare of a fair amount of the general populace (and this, due in large part simply to their innate lack of energy to come to their own investigative conclusions). Your essays (including tone) could go a long way toward presenting a more balanced ‘voice’ – and one that reconstitutes a great deal of the finer points of critical discourse – while in process, bringing back a necessary weighing of both sides to the complex issues of the day. I for one am weary of "opinionators" that (mostly) abuse syntactic logic via monophonic journalistic sledgehammer-like diatribes rather than taking up the (often needed) delicate 2-hair brush of more thoughtful considerations. By commenting on important topics with balanced deliberation (such as you do) at the end of the day, it matters less whether the palette of the columnist has a bent coming from the left or the right, since a fair hearing of a considered train of thought is all that is being requested.
- Sky

My wife Ronnie often asks why I take the trouble to compose these BLOGs; not so subtly she implies a misspent ego. Maybe she's right. Maybe I get off finding out whether, or not, my ideas are good enough to stimulate others' thinking? If so, I can't remember being so rewarded as opening tonight's mail to see M.Rex's (King's) journalsitically-polished polemic and SKY (Yeatts) poetic stylings. Seriously, I'll address the substance of both comments in further comments or a near-future new post. Meanwhile, I just wanted to thank both of them for their "trouble."